Tuseran® Forte has a powerful formulation made especially for cough and cold. It can provide relief in as fast as 15 minutes!
This medicine contains dextromethorphan HBr, phenylpropanolamine HCl and paracetamol.
Tuseran® Forte is used for the relief of cough, clogged nose, postnasal drip, headache, body aches, and fever associated with the common cold, allergic rhinitis, sinusitis, flu, and other minor respiratory tract infections. It also helps decongest sinus openings and passages.
Adults and Children 12 years and older: Orally, 1 capsule every 6 hours, or as recommended by a doctor.
Tuseran® Forte is available in all leading drugstores nationwide for PHP 10.00 per capsule.
If you miss a dose, just take the next dose if still needed for the condition being treated, and the subsequent doses at the recommended time or schedule (i.e., every 6 hours).
Do not double the dose.
If you have taken more than the recommended dosage, consult a doctor or contact a poison control center right away, even if you seem well, because of the risk of delayed, serious liver damage. Quick medical attention is important for adults as well as for children even if you do not notice any signs or symptoms.
Adverse effects with dextromethorphan are rare and include nausea, vomiting, stomach discomfort, constipation, dizziness, drowsiness, excitation, and mental confusion. Hypersensitivity reactions have also been reported.
Phenylpropanolamine HCl may cause sudden, persistent, severe headache, nervousness, restlessness, insomnia/sleep disturbance, dizziness, anxiety (feeling of uneasiness), confusion, high blood pressure, palpitation, chest tightness, tremor, agitation, irritability, aggressiveness (particularly in young children), nausea, and blurred vision.
Paracetamol, when taken within the recommended dose and duration of treatment, has low incidence of side effects. Skin rashes, hypersensitivity reactions, changes in the number of white blood cells and platelets, and minor stomach and intestinal disturbances have been reported. Rare cases of serious skin reactions (i.e., Stevens-Johnson syndrome, toxic epidermal necrolysis, and acute generalized exanthematous pustulosis) have also been reported.
Do not use this product together with sympathomimetic agents (e.g., epinephrine) and general anesthetics (e.g., halothane) because of the possibility for increased toxicity.
Concurrent administration with monoamine oxidase (MAO) inhibitors (e.g., selegiline, moclobemide) and tricyclic antidepressants (e.g., amitriptyline, imipramine) may result in hypertensive crisis (sudden, severe increase in blood pressure that can lead to stroke).
Combined use of phenylpropanolamine and caffeine may produce an additive increase in blood pressure. Severe, life threatening, and occasionally fatal hypertensive reactions have been reported.
Dextromethorphan is primarily metabolized by the cytochrome P450 isoenzyme CYP2D6. There is a possibility of interaction with inhibitors of this enzyme, including amiodarone, haloperidol, propafenone, quinidine, selective serotonin reuptake inhibitors (SSRIs), and thioridazine. Symptoms of dextromethorphan toxicity have been reported when used together with amiodarone and quinidine.
Additive central nervous system (CNS) depression may occur when dextromethorphan is taken together with alcohol, antihistamines, psychotropics and other CNS depressants.
Paracetamol, when used together with warfarin (a blood-thinning medicine), may cause an increase in the International Normalized Ratio (INR), which may serve as a sign of increased risk for bleeding. Paracetamol increases the anticoagulation effect of warfarin.
Medicines which stimulate the enzymes responsible for the metabolic activation of paracetamol such as medicines for convulsion (e.g., phenobarbital, phenytoin) may increase susceptibility to the harmful effects to the liver.
The absorption of paracetamol may be accelerated by metoclopramide or domperidone and reduced by cholestyramine.
Tell your doctor about other medicines you are taking (i.e., other medicines for cough, cold, allergy, pain, or fever, especially other paracetamol-containing products).
Acute overdosage of dextromethorphan may cause nausea, vomiting, drowsiness, dizziness, excitation, confusion, psychosis, CNS depression, stupor (decrease mental alertness), blurred vision, nystagmus (involuntary and rapid movement of the eyeball), dysarthria (slurred speech), respiratory depression, shallow respiration, ataxia (uncontrolled muscle movement), tremor, urinary retention, seizures, and coma.
Signs and symptoms of phenylpropanolamine overdosage include tachycardia, arrhythmia (irregular heart beat), high blood pressure, excitation, enlargement of the pupils. Cases of heart attack, stroke, intracranial hemorrhage/cerebral hemorrhage (bleeding from a ruptured blood vessel in the brain), seizures, and death have also been reported.
Overdosage of paracetamol usually involves 4 phases with the following signs and symptoms:
I. Eating disorder, nausea, vomiting, malaise, and excessive sweating
II. Right upper abdominal pain or tenderness, liver enlargement which may be characterized by abdominal discomfort of "feeling full", elevated bilirubin and liver enzyme concentrations, prolongation of prothrombin time, and occassionally decreased urine output
III. Eating disorder, nausea, vomiting, and malaise recur and signs of liver failure (e.g., jaundice) and possibly kidney failure and cardiomyopathy (disorder of the heart muscle) may develop
IV. Recovery or progression to fatal complete liver failure